Operating Model
Individuals can first register to become a Member by signing up at www.qolaq.org. Registration involves providing personal information, such as name, email address, and etc. Following completion of registration, the individual will need to link their digital wallet and then to purchase at least one (1) USDC to be able to join any of QolaQ’s MAP Programs.
As opposed to taking the rigid, centralized approach of insurance providers, QolaQ seeks to create a decentralized, Member-driven MAP. QolaQ’s MAP eliminates intermediaries, such as insurance agents, enabling its Members to conduct transactions through smart contracts and sophisticated security protocols. To provide a viable solution, QolaQ’s MAP seeks to encompass the following key elements:
Enhanced security and privacy protections of Members' data;
Decentraliztion empowering the Members to decide payouts;
Ecosystem activities enabled via USDC;
Program offerings which provide value to Members with straightforward terms and conditions;
Blockchain technology to facilitate Member activities on the MAP;
KYC/AML policies to ensure appropriate compliance; and
Clear procedures for effectively processing and resolving claims.
Registration and Voting
Anyone can join and become a member of the QolaQ community – provided they are neither on the United Nations Sanctions list nor a resident of either Iran, North Korea, or Syria – by signing up on QolaQ’s website or app. In order to register, prospective Members have to provide personal information such as full name, email address, and phone number. Once the prospective member has given this information, individual will be allocated a QolaQ wallet. However, to safeguard against fraud and protect the MAP, Members’ identities must be verified. As such, to become a full member of QolaQ, the member must provide additional information, such as country of residence, date of birth, gender, and personal attestation that the member in question is not a political exposed person. Once they have confirmed their identity, prospective members will then connect a digital wallet to their QolaQ account and purchase a minimum number of USDC. After this initial purchase, Members will be able to join one or more of QolaQ’s MAP Programs. For the MAP Life Program, the Member will also need to designate beneficiary information, including full name, email address, phone number and wallet details.
Simple Critical Illness Program (“SCIP”)
After a Member joins the MAP SCIP, there is a waiting period of three (3) months before being eligible to submit a claim. During the waiting period, a Member will not be able to submit a claim. After passing the waiting period, a participating Member can make a claim by confirming that the personal information uploaded is still accurate. To submit a claim, the participating Member will need to upload diagnosis information and medical documentation which will be used to verify the claim. To address potential concerns regarding fraud, QolaQ’s MAP utilizes a team of claim scorers to review the claim based on the documentation provided. After the claim is scored, it is sent to fellow SCIP Members to be voted upon. When voting, there are three (3) selections that Members can make: (1) “Approve”, (2) “Reject” or (3) “Abstain”. Members may also request additional investigation. If a majority of Members vote to Approve, then the payout will be prepared for transfer to the claimant’s QolaQ wallet (after deducting the MAP's Admininstrative Contribution). Prior to receiving the payout, the claimant will need to provide a copy of their government issued identification.
Life program (“LP”)
To join the MAP LP, a member must provide a government issued identification. After joining the MAP LP, there is a waiting period of six (6) months before the Member’s beneficiary may file a claim. During the six (6) month waiting period, beneficiaries are not eligible to make a claim. The person filing the claim must be the beneficiary designated by the Member at the time of registration. If the beneficiary does not have a QolaQ account, the beneficiary will need to register, using the same email address as the one that the Member originally filed. After passing the waiting period, the beneficiary can make a claim by verifying the Member’s personal information as requested by QolaQ. The beneficiary will also need to submit the related documentation for filling the claim, including government issued identification. To address potential fraud, the MAP utilizes a team of claim scorers to review the claim based on the documentation provided. After the claim is scored, it is sent to fellow LP Members to be voted upon. When voting, there are three (3) selections that Members can make: (1) “Approve”, (2) “Reject” or (3) “Abstain”. Members may also request additional investigation. If a majority of Members vote to Approve, then the payout will be prepared for transfer to the beneficiary's QolaQ wallet (after deducting the MAP's Admininstrative Contribution). Prior to receiving the payout, the beneficiary will need to provide a copy of their government issued identification.
Member Benefits and Processes
Members are planned to make an Annual Membership Contribution upon the creation and renewal of their membership. Members will also make a contribution from each claim payout, after first deducting the direct costs associated with each claim (e.g., verification of the supporting documentation).
QolaQ MAP offers considerable savings to its Members as compared with digital and traditional insurance providers, especially via the avoidance of costs associated with legacy systems and practices (e.g., claim processing costs, agency fees). Building on blockchain technology enables QolaQ to provide a solution that ensures an automated and secure environment. Specifically, in the case of QolaQ’s MAP, there are no upfront, recurring premiums. Additionally there are no agency commissions or underwriting. In fact, instead of the case-by-case claim approval process imposed by underwriting, MAP claims are voted on by Members as soon as all the documentation has been filed. Figure 2 provides an overview of QolaQ’s MAP flow:
A. Payout & Contribution Calculation Upon joining a Program
A Member is expected to be assigned a specific payout amount which is dependent on several factors, such as:
Entry age, or age when the Member joins the MAP;
Gender;
Country of domicile; and
Program(s) selected.
Age, gender, and country of domicile are factors to ensure fairness within the MAP community. For instance, the older the age of a Member generally equates to a higher prevalence of claims. The same concept applies to different countries, depending on their mortality and morbidity rates. By considering these various factors, QolaQ seeks to ensure that the MAP is not benefiting certain subgroups of Members at the disadvantage of others. Additionally, different Programs (for example Simple Critical Illness compared with Life) may have different payout calculations based on the age, gender, and country of the Members participating.
B. Claim Adjudication & Voting
QolaQ is implementing a Member-driven claims process. Following the logging of a claim request, the MAP is expected to automatically initiate the process such that the Member submitting the claim is required to upload certain required documents. For instance, a SCIP claim may require such items as either a diagnosis letter or copies of test results.
After submitting the necessary materials to the MAP, the Claim Scorers are expected to conduct checking to review the documentation and institute an investigation, if needed. The Claim Scorers are planned to then assign a claim score based on such criteria as:
Validity and normality of the claim;
Pre-existing conditions (conditions existed before the Member joined QolaQ’s MAP); and
Potential factors to consider (e.g., if the claim was associated with a crime or was self-inflicted).
Once the Claim Scorers’ report is distributed for Member consideration, the process is planned to be based on a simple majority vote, in which each Member will be eligible to submit one (1) vote.
Smart Contracts
All transactions on the MAP are conducted in USDC using smart contracts. This enables Members to conduct transactions without the need for intermediaries, reducting transaction costs. The operations within QolaQ MAP, including contributions and claim payouts, are facilitated via the Members’ digital wallets using USDC. Besides reducing transaction costs, utlizing smart contracts ensure that Members are not exposed to any greater risk than their respective allocation in meeting the obligations of the claim, which are automatically executed, and recorded on chain. Additionally, smart contracts enable QolaQ’s MAP to function optimally, including, but not limited to, providing:
Agreements with the Members to be immutable;
Mechanism for Members to be directly involved in claim adjudication;
Platform for Members to participate in governance; and
Enhanced security.
In addition, Members can be reluctant to ask for critical illness support for fear of disclosing personal information. This apprehension is being resolved via QolaQ’s MAP, as QolaQ’s smart contracts maintain each Member's privacy and data security while at the same time delivering fair and impartial participation in QolaQ’s MAP.
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